Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 225
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP/CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
210 E CARPENTER ST, SPRINGFIELD, IL 62702-5128
(217) 528-3193
(217) 528-3196
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
(217) 221-5641
(217) 221-5929
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.018139
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138093
PK
—
Enumeration date
12/05/2012
Last updated
09/27/2021
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